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Eli Lilly, Developing Cymbalta, 2008

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It will be more effective for Cymbalta to have an additional indication of efficacy in treating pain than once-a-day dosing for Major Depressive Disorder (MDD). There are many drugs available on the market claiming to treat depression, which have already been proven effective. However, there are currently no drugs on the market that can treat chronic pain in addition to depression. Thus, it would be to the advantage of Eli Lilly to strategically pursue clinical studies of Cymbalta for the pain indication. The goal of Eli Lilly is to develop a successor to their blockbuster antidepressant drug, Prozac, which only has a few years remaining on its patent protection. Therefore, the looming introduction of competing generic drugs and the soon to be approved Paxil are in the midst of potentially taking away some of its market share. The antidepressant drug market is highly competitive (See APPENDIX A), which means that companies must spend a lot to promote and advertise these products to remain viable. Of note, many patients that suffer from depression also have other underlying issues such as chronic pain in the head, neck and/or shoulders. Unfortunately, in the past physicians had not taken the pain aspect very seriously. In fact, many physicians/psychiatrists believed that the pain did not really exist, and was merely in the minds of the patients that were suffering from depression. Neurologists on the other hand, postulated that the presence of physical pain could cause depression, hence it is important to treat for pain when treating depression. Recent studies have connected aspects of depression to pain, such as depression representing a state, when lower levels of serotonin and norepinephrine lead to the combined manifestation of both emotional and painful physical symptoms. It has been shown that 5% – 20% of the depression sufferers also experience chronic pain.

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